Provider Demographics
NPI:1184047227
Name:VISIONS COUNSELING II, LLC
Entity type:Organization
Organization Name:VISIONS COUNSELING II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GWENDDOLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTELL-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:715-551-1970
Mailing Address - Street 1:N2355 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-9453
Mailing Address - Country:US
Mailing Address - Phone:715-551-1970
Mailing Address - Fax:715-539-3580
Practice Address - Street 1:N2355 SMITH RD
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-9453
Practice Address - Country:US
Practice Address - Phone:715-551-1970
Practice Address - Fax:715-539-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-25
Last Update Date:2014-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7612-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health